Earlier this month, an appellate court in Utah issued a written opinion in a personal injury case presenting an issue that often arises in Maryland pharmacy error and medical malpractice cases. The issue was whether the plaintiff’s expert’s testimony should be excluded from evidence because it was late-filed, and if so, whether the plaintiff’s case should be dismissed for failing to present necessary evidence.

The Facts of the Case

The plaintiff sued her pharmacy, claiming that it overprescribed drugs. However, at the time she filed the case, the plaintiff did not designate any expert who would be testifying in support of her case. It was not until the day of the summary judgment hearing that the plaintiff presented the court with the name and information of her expert witness.

Upon the defendant’s motion, the court precluded the plaintiff’s expert from testifying, finding that the expert’s information was provided well past the discovery deadline. After striking the plaintiff’s expert’s testimony, the court then determined that the plaintiff was unable to prove her claim against the pharmacy and dismissed the plaintiff’s claim.

The online retail giant Amazon recently announced that it would soon be entering the pharmacy business. With Amazon’s impressive delivery network, the company believes that it has a service to offer those who would otherwise need to travel to the nearest pharmacy to fill their prescription. Some believe that Amazon’s entrance into the pharmacy business may reduce the number of Maryland prescription errors.

Due to the volume of transactions that Amazon handles annually, some are seeing Amazon’s entrance into the pharmacy business as an opportunity for the industry to make major strides toward a safer process. The idea is that Amazon has the clout necessary to make pharmaceutical companies make changes to the way drugs are packaged and marketed.

According to a recent industry news report, the leading cause of pharmacy errors is inadvertence. Simply stated, most pharmacy errors are results of a busy pharmacist grabbing the wrong medication because its name or packaging is so similar to the medication the patient requires. And, according to the article, drug manufacturers have little reason to change because they are not normally held liable for errors. However, the article notes that as Amazon enters the business, the company may be able to use its influence to require manufacturers to make changes to the way companies package and market their drugs, potentially resulting in an overall decrease in the amount of pharmacy errors.

As is the case with most professions, becoming a pharmacist involves not only getting an education but also obtaining the necessary hands-on experience. Of course, as medical professionals, pharmacists are responsible for the safety of their patients, and any Maryland pharmacy error made by a trainee can have potentially drastic consequences for a patient’s health. Thus, normally, pharmacists in training are closely supervised to ensure that any mistakes they make are caught and fixed before the prescription is passed on to the patient. However, providing this level of supervision is costly to pharmacists, and too often efficiency is favored over safety.

In a recent article discussing the high frequency of pharmacy errors and potential ways to cut back on the number of errors, it was suggested that pharmacists may make fewer mistakes once they are certified to work on their own if they are allowed to make mistakes in training. The proposition is not a surprising one, since it has often been said that “practice makes perfect.” However, in the context of the medical field, patients rightfully expect “perfect” performance when it comes to filling their prescriptions.

The article discusses one pharmacist’s experiences in training and proposes a method to ensure that pharmacists in training are able to make the mistakes they need to make and learn from them. For example, the pharmacist explained that he would have to fill 1,000 prescriptions in a row without an error before he could move on to his next exercise. If he made a single error anywhere along the way, he would start back at zero. He explained the frustrating in reaching 200 prescriptions several times, only to make a minor error.

Pharmacy errors present a serious risk of injury not just to patients who take medication that they need to keep them healthy but also to anyone who fills a prescription. In many cases, Maryland pharmacy errors involve a patient being provided with a dangerous medication that they were not prescribed. This can result in a wide range of dangerous side effects, up to and including death.

Given the risks involved, pharmacists generally take their job very seriously and want to ensure that their patients are given exactly the medication and dosage they are prescribed. However, pharmacies are for-profit corporations that exist to make money. And by scheduling fewer pharmacists, the pharmacy is spending less in labor costs and can keep more of the money it receives.

According to a recent news report, some pharmacists have recently expressed frustration with the fact that they are pressured to fill prescriptions quickly, focusing more on filling a large number of prescriptions than making sure the prescriptions that are filled are accurate. These employees told reporters that they felt as though their employers viewed the occasional pharmacy error as a “cost of doing business.”

Prescription errors can have devastating consequences for Maryland patients. These types of errors can be caused by a number of different issues, including writing the wrong prescription and dispensing the wrong medication. Some of these errors may be reduced by changing something as simple as the packaging of the medication. Some drugs have similar names, and other bottles look alike, increasing the likelihood of error. Experts are pushing companies to make changes in cases of confusing labeling, naming, and packaging.

In a prescription error case, an individual must show that the defendant was negligent in doing or failing to do something by failing to meet the standard of care required. This might include failing to properly read the label on a medication bottle. However, industry experts are working to help medical professionals avoid such errors.

FDA Guidance Seeks to Reduce Errors Due to Labeling and Packaging

Look-alike and sound-alike medications increase the likelihood of prescription errors, according to one news source. One report found that 33 percent of all medication errors and 30 percent of deaths from medication errors resulted from issues with medication labeling and packaging.

In the pharmacy world, it is well-known that diabetic patients are among those with the highest risk of being victims of Maryland medication errors. This is due mostly to the fact that diabetic patients are often required to take several medications in a very specific dose, as well as the fact that a failure to get the medication (or too large a dose of the medication) will likely result in an adverse health event.

According to a recent study, those patients who suffer from Type 1 diabetes are more likely than patients with Type 2 diabetes to experience a medication error. The study followed 671 diabetic adults who were admitted to the hospital. Researchers tracked the patients from admission until discharge and double-checked each administration of medication. As it turned out, about 30% of patients experience at least one error.

The most common type of error accounted for roughly 60% of all errors and was an error of omission. When this type of error occurs, a patient is not given the medication that they were prescribed by their physician. Other common error types were wrongly added medications and improperly administered medications.

While all prescription drugs pose risks if taken in large quantities or by certain patients taking other medications, some medications have such a high likelihood of being involved in a Maryland pharmacy error that they have been labeled as “high-alert” medications. According to a recent industry news report, high-alert medications are those that have an increased probability of negative interaction when taken with another commonly prescribed drug, have serious side effects even when taken alone, or must be taken in very specific doses to ensure that the medication is effective.

While many types of medication are high-alert, some commonly seen high-alert medications in out-patient pharmacies are chemotherapy medication, pediatric solutions, insulin, and opioids. The list of high-alert medications in hospital pharmacies is similar and includes epinephrine and hypoglycemic agents. That being said, it is understood that insulin presents the highest risk of all medications, due to the various forms and doses of the drug as well as the high-risk status of many insulin patients.

The article details certain steps that pharmacies should implement when filling prescriptions for high-alert medications. For example, using system alerts whenever a pharmacist fills a high-alert medication triggers a cue for the pharmacist to provide additional counseling to the patient regarding the high-alert medication. System alerts may also be set to alert pharmacists to patients who present an especially high risk of being a victim of an error.

Most people would like to think that if they were ever given an incorrect prescription by a pharmacist, they would catch the mistake. However, statistics indicate that most people who are provided with the wrong medication, incorrect dose, or improper instructions at the pharmacy counter do not notice the error until they have taken the medication home and ingested at least one dose.

When dealing with visually impaired patients, there is a drastic reduction in the chance that the patient will notice the error. This pertains not just to those who are legally blind but also to the elderly or others with poor vision. A patient with compromised eyesight may be able to see well enough to find their way to the pharmacy counter but will likely have difficulty reading the small print on prescription bottles.

Pharmacists have a duty to fill all patients’ prescriptions accurately, and they may be held liable for any injuries that result from an error. Under the law as it pertains to pharmacy error claims, a visually impaired patient will not be expected to catch the error. That is to say that the pharmacist will not be able to argue that the patient should have caught the error in an attempt to avoid liability.

In the old days, a pharmacist’s job hardly resembled what it does today. With hundreds of patients coming in to fill tens of thousands of prescriptions each month, the average pharmacist is extremely busy. This leaves them with little time to spend with each patient, and it may even result in the pharmacist rushing through important safety measures just to keep up with the workload.

The situation in hospital pharmacies is similar; with patients constantly being admitted and discharged, it can be difficult for pharmacists to keep all of the patients and medications straight. This has led hospitals across the country to rely more on technology. And it seems to be working in reducing Maryland pharmacy error rates and rates in other states.

According to a recent news article, the use of electronic health records (EHRs) and computerized prescriber-order-entry (CPOE) systems has greatly reduced the number of medication errors in hospitals nationwide. As a result, these systems have been widely adopted, with approximately 99% of hospitals using EHRs and 97% of hospitals using CPOE systems to fill at least some portions of the prescriptions filled in the hospital.

Patients have to put a great deal of faith in their doctors, nurses, and pharmacists. We put our lives in the hands of medical providers. But medical providers can make mistakes just like anyone else. Since medication errors occur all too frequently, doctors, nurses, and pharmacists have to be vigilant in making sure that every patient is getting the right medication.

Proving Negligence in Medication Error Cases

To recover damages in a Maryland medication error case, a plaintiff must show that the defendant acted negligently. Negligence can be shown by demonstrating that the defendant was negligent in doing or failing to do something. A plaintiff must show the following elements: the defendant had a legal duty to use due care toward the plaintiff, the defendant failed to perform that duty, the plaintiff suffered damages, and the defendant’s failure to perform the required duty caused the plaintiff’s damages.

Examples of damages available to medication error victims include medical expenses, lost wages, physical therapy, and loss of earning capacity.

Disclaimer:
While all of the cases identified in the Lebowitz & Mzhen, LLC website under Our Successes are cases that Lebowitz & Mzhen, LLC has handled for its clients, Lebowitz & Mzhen, LLC does not represent any of the clients in cases mentioned in our blog. Our law firm is reporting on current events that will likely be of interest to our readers. The content provided is not intended as legal advice.